PMID- 33111853 OWN - NLM STAT- MEDLINE DCOM- 20201204 LR - 20210828 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 115 IP - 4 DP - 2020 Oct TI - Current Impact of Cardiopulmonary Bypass in Coronary Artery Bypass Grafting in Sao Paulo State. PG - 595-601 LID - S0066-782X2020001200595 [pii] LID - 10.36660/abc.20190145 [doi] AB - BACKGROUND: Previous results on the use of cardiopulmonary bypass (CPB) have generated difficulties in choosing the best treatment for each patient undergoing myocardial revascularization surgery (CABG) in the current context. OBJECTIVE: Evaluate the current impact of CPB in CABG in Sao Paulo State. METHODS: A total of 2905 patients who underwent CABG were consecutively analyzed in 11 Sao Paulo State centers belonging to the Sao Paulo Registry of Cardiovascular Surgery (REPLICCAR) I. Perioperative and follow-up data were included online by trained specialists in each hospital. Associations of the perioperative variables with the type of procedure and with the outcomes were analyzed. The study outcomes were morbidity and operative mortality. The expected mortality was calculated using EuroSCORE II (ESII). The values of p <5% were considered significant. RESULTS: There were no significant differences concerning the patients' age between the groups (p=0.081). 72.9% of the patients were males. Of the patients, 542 underwent surgery without CPB (18.7%). Of the preoperative characteristics, patients with previous myocardial infarction (p=0.005) and ventricular dysfunction (p=0.031) underwent surgery with CPB. However, emergency or New York Heart Association (NYHA) class IV patients underwent surgery without CPB (p<0.001). The ESII value was similar in both groups (p=0.427). In CABG without CPB, the radial graft was preferred (p<0.001), and in CABG with CPB the right mammary artery was the preferred one (p<0.001). In the postoperative period, CPB use was associated with reoperation for bleeding (p=0.012). CONCLUSION: Currently in the REPLICCAR, reoperation for bleeding was the only outcome associated with the use of CPB in CABG. (Arq Bras Cardiol. 2020; 115(4):595-601). FAU - Borgomoni, Gabrielle Barbosa AU - Borgomoni GB AUID- ORCID: 0000-0002-9243-7407 AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Mejia, Omar Asdrubal Vilca AU - Mejia OAV AUID- ORCID: 0000-0002-1635-4984 AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. AD - Hospital Samaritano Paulista, Sao Paulo, SP - Brasil. FAU - Orlandi, Bianca Maria Maglia AU - Orlandi BMM AUID- ORCID: 0000-0002-4672-6494 AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Goncharov, Maxim AU - Goncharov M AUID- ORCID: 0000-0003-4820-8399 AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Lisboa, Luiz Augusto Ferreira AU - Lisboa LAF AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Conte, Pedro Henrique AU - Conte PH AUID- ORCID: 0000-0002-3020-6398 AD - Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Oliveira, Marco Antonio Praca AU - Oliveira MAP AD - Beneficencia Portuguesa de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Fiorelli, Alfredo Inacio AU - Fiorelli AI AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Petrucci Junior, Orlando AU - Petrucci Junior O AD - Universidade Estadual Campinas FCM Unicamp - Faculdade de Ciencias Medicas, Campinas, SP - Brasil. FAU - Tiveron, Marcos Grandim AU - Tiveron MG AD - Hospital Santa Casa de Misericordia Marilia, Marilia, SP - Brasil. FAU - Dallan, Luis Alberto de Oliveira AU - Dallan LAO AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. FAU - Jatene, Fabio Biscegli AU - Jatene FB AD - Universidade de Sao Paulo - Faculdade de Medicina Hospital das Clinicas - Instituto do Coracao, Sao Paulo, SP - Brasil. LA - eng LA - por PT - Journal Article PT - Research Support, Non-U.S. Gov't TT - Impacto Atual da Circulacao Extracorporea na Cirurgia de Revascularizacao Miocardica no Estado de Sao Paulo. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 SB - IM CIN - Arq Bras Cardiol. 2020 Oct;115(4):602-603. PMID: 33111854 MH - *Cardiopulmonary Bypass MH - *Coronary Artery Bypass MH - Humans MH - Male MH - Myocardial Revascularization MH - Reoperation MH - Treatment Outcome PMC - PMC8386981 OAB - BACKGROUND: Previous results on the use of cardiopulmonary bypass (CPB) have generated difficulties in choosing the best treatment for each patient undergoing myocardial revascularization surgery (CABG) in the current context. OBJECTIVE: Evaluate the current impact of CPB in CABG in Sao Paulo State. METHODS: A total of 2905 patients who underwent CABG were consecutively analyzed in 11 Sao Paulo State centers belonging to the Sao Paulo Registry of Cardiovascular Surgery (REPLICCAR) I. Perioperative and follow-up data were included online by trained specialists in each hospital. Associations of the perioperative variables with the type of procedure and with the outcomes were analyzed. The study outcomes were morbidity and operative mortality. The expected mortality was calculated using EuroSCORE II (ESII). The values of p <5% were considered significant. RESULTS: There were no significant differences concerning the patients' age between the groups (p=0.081). 72.9% of the patients were males. Of the patients, 542 underwent surgery without CPB (18.7%). Of the preoperative characteristics, patients with previous myocardial infarction (p=0.005) and ventricular dysfunction (p=0.031) underwent surgery with CPB. However, emergency or New York Heart Association (NYHA) class IV patients underwent surgery without CPB (p<0.001). The ESII value was similar in both groups (p=0.427). In CABG without CPB, the radial graft was preferred (p<0.001), and in CABG with CPB the right mammary artery was the preferred one (p<0.001). In the postoperative period, CPB use was associated with reoperation for bleeding (p=0.012). CONCLUSION: Currently in the REPLICCAR, reoperation for bleeding was the only outcome associated with the use of CPB in CABG. (Arq Bras Cardiol. 2020; 115(4):595-601) OABL- eng COIS- Potencial Conflito de Interesses Declaro nao haver conflito de interesses pertinentes. EDAT- 2020/10/29 06:00 MHDA- 2020/12/15 06:00 PMCR- 2020/10/13 CRDT- 2020/10/28 09:01 PHST- 2019/03/13 00:00 [received] PHST- 2019/08/18 00:00 [accepted] PHST- 2020/10/28 09:01 [entrez] PHST- 2020/10/29 06:00 [pubmed] PHST- 2020/12/15 06:00 [medline] PHST- 2020/10/13 00:00 [pmc-release] AID - S0066-782X2020001200595 [pii] AID - abc.20190145 [pii] AID - 10.36660/abc.20190145 [doi] PST - ppublish SO - Arq Bras Cardiol. 2020 Oct;115(4):595-601. doi: 10.36660/abc.20190145.